MEDICARE: ANDRES M NARANJO IDC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1710I1002X	Independent Duty Corpsman
2	1710I1003X	Independent Duty Medical Technicians

General Provider Information

NPI Number	:	1669604757
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANDRES M NARANJO IDC

Provider Business Mailing Address
First Line	:	107 PICKETT CREEK LN
Second Line	:
City	:	BLUFFTON
State	:	SC
Zip	:	29909-7823
Country	:	US
Telephone Number	:	904-349-6937
Fax Number	:

Provider Business Practice Location Address
First Line	:	1050 REMOUNT RD BLDG 3107
Second Line	:
City	:	NORTH CHARLESTON
State	:	SC
Zip	:	29406-3516
Country	:	US
Telephone Number	:	843-794-0053
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/22/2009
Last Update Date	:	02/10/2026

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